銩雷射應用於大於80公克攝護腺刮除手術的使用治療經驗
李宗叡、黃志平、吳錫金、謝博帆、張兆祥、楊啟瑞、陳汶吉、鄒頡龍、連啟舜、陳冠亨
中國醫藥大學附設醫院 泌尿部
Thulium Laser Treatment for Large Prostate (80 gm)- CMUH experience
Tzung-Ruei Li, Chi-Ping Huang, His-Chin Wu, Po-Fan Hsieh, Chao-Hsiang Chang, Chi-Rei Yang, Wen-Chi Chen, Chieh-Lung Chou, Chi-Shun Lien, Guang-Heng Chen, Yi-Huieh, Chang
Department of Urology, China Medical University Hospital, Taichung, Taiwan

Purpose:
The aim of this study is to offer our management experience to the larger prostate (80ml) by using Thulium laser.

Materials and Methods:
Our cohort recruited 165 patients between July 2015 and March 2019 who had larger size of prostate, which defined as above 80ml by using either transrectal or transabdominal ultrasound, and further received Thulium laser surgery. We analyzed the post-operative outcomes, including the need of medication and complication. All statistical analysis was performed with SPSS 22.0.

Results:
The average size of the prostate was 106.07ml. The average post-op Foley insertion duration was 4.02 days, and the length of hospitalization was 5.12 days. Only two of them had fever after the admission. After the surgery, only 11 patients (6.7%) needed medication(a-blockers) after the surgery. All the patient did not need the Foley or cystotomy after the surgery after 1 month. 8 (4.8%) patients need sounding for the urethral strictures. The pre-operative PSA was 20.41, and the post-operative PSA was 2.20. We further compared 20 of the patients had pre-operative and post-operative maximum flow rate (Qmax), and showed increase 10.3 ml/sec in average.

Conclusions:
Our cohort showed good effectiveness and safety for using Thulium laser dealing with the large prostate bigger than 80 grams. The post-operative outcomes including the need of medication and Foley, reduction of PSA, increase of Qmax showed satisfying.